ego states and dissociation

This paper, using an illustrative case study, presents the hypothesis that cyclical spouse abusers suffer from a dissociative condition (or perhaps a personality disorder in which dissociation is a prominent feature) that results from disorganized attachment. The partner of the spouse abuser tries various unsuccessful strategies to appease her spouse in order to change his behavior. If the relationship lasts for years, she adapts by developing a milder but parallel dissociative process, developing chains of state-dependent memory and resultant ego states for the different phases of the domestic abuse cycle...

Therapy with seriously dissociated patients requires the transformation and integration of malevolent ego states that produce a wide assortment of negative experiences and behaviors in the patient. During the course of therapy, they can present dangers to both patient and therapist, as well as to the therapeutic process (Watkins & Watkins, 1984). Perhaps the greatest challenges for therapists in this work are the development and the maintenance of empathy for these personality aspects. Without some degree of empathy, a healing therapeutic alliance cannot be formed, and absent a secure, healing, intersubjective experience, it is unlikely that malevolent ego states can undergo sufficient transformation for integration...

This article takes its inspiration from Wickramasekera II's empathic involvement theory of hypnosis. That model illuminates the mutual territory of hypnosis and empathy-common to much interaction between hypnotist and subject, and to the internal process of subjects as they enact suggestions of the hypnotist. However, the present article suggests that the overlap is not as ubiquitous as the empathic involvement theory asserts. Other aspects of hypnosis involve disengagement from real persons in the environment and dissociating from other ego states of the self...

Psychoanalytic models have a commonly held view of necessary and accurate mirroring in the dialectic of emergent and already formed aspects of the self. Mirroring-perplexity, however, is a cognitive and affective state found in a group of patients for whom reflective mirroring results in a dissociative rather than a unifying experience of body and mind. A review of the myth of Narcissus reveals that mirroring requires a relational mediation of self and mirror image through another. This ontological organization affectively links the simultaneous sense of being in the body and in the reflected image after experiencing a state of dyadic union...

Ego state therapy has often been cited as an effective treatment to help repair fragmentation related to posttraumatic stress and dissociative disorders. This article explores how specialized work with ego states can help to clarify and strengthen internal and external boundaries, create greater boundary flexibility, and contribute to containment and self-regulation. Applications of direct and indirect hypnosis to repair boundary issues through ego state therapy are emphasized, and clinical case examples are used to illustrate results...

Evil deeds may be committed intentionally or out of madness, but it is those who follow orders that present us with the most complex moral, philosophical and psychological questions. In writing about the banality of evil, Hannah Arendt argues that "in granting pardon, it is the person and not the crime that is forgiven; in rootless evil there is no person left whom one could ever forgive." Arendt postulates that "being a person" necessarily entails the acts of memory and thought. This paper explores Arendt's ideas on memory and thought and how these processes can become subverted in the service of a higher order...

Dissociative disorders (DD) prevail as sequelae to overwhelming experiences in childhood. These readily formed post-traumatic responses and trance states develop in high hypnotizable subjects whose dysregulations become organized into ego states. A cognitive behavioral hypnotherapeutic treatment model will effectively contain, explore, metabolize, and resolve these life-endangering conditions. This article will detail the cognitive hypnotic world of DD patients, the relational spaces of the ego states, and the triphasic treatment mode to successfully resolve the dissociative pathology...

The history of hypnosis is closely linked to the theme of possession; one such link is that the forerunner of hypnosis, animal magnetism, replaced exorcism in 1775 when Franz Anton Mesmer testified against Father Johann Joseph Gassner's exorcism. Modern authors have noted remarkable similarities between states of possession and dissociation. The treatment of possession by animal magnetism and exorcism represents the special romantic-magnetic therapy of the German medical doctor Justinus Kerner in the early 19th century...

The ability to think about oneself--to self--reflect--is one of the defining features of the human mind. Recent research has suggested that this ability may be subserved by a particular brain region: the medial prefrontal cortex (MPFC). However, although humans can contemplate a variety of different aspects of themselves, including their stable personality traits, current feelings, and physical attributes, no research has directly examined the extent to which these different forms of self-reflection are subserved by common mechanisms...

This article reports on the use of hypnosis to facilitate the diagnostic process and the treatment of an unusual case of adult psychogenic amnesia. An Iraqi citizen living in the U.S. developed an atypical case of Dissociative Amnesia, Systematized type, post-automotive collision. The amnesia presented with features encompassing complete loss of the patient's native language. Dissociation theory as a conceptualization of hysterical reactions was employed as the basis in the formulation of this case. The differential diagnosis was facilitated by the Hypnotic Diagnostic Interview for Hysterical Disorders (HDIHD) Adult Form, an interview tool specifically designed for cases such as this...

Agnosias demonstrate the broadest spectrum of pathology of consciousness in neurology and psychiatry. Agnosias wipe off the definite functions from the brain's activity precisely and completely, allowing the consciousness to be investigated in itself. Thorough investigations of confabulatory manifestations disclose the rationale for the development of pathological functions and point out that there is a remedial (reconstructive) sense behind the senselessness of a mental state. Pathology seems to be accompanied by involuntary reparation on the part of the brain...

Most clinicians working with dissociative identity disorder (D.I.D.) recognize the importance of working towards a cooperative system especially during the initial stages of treatment. However, achieving this can be a monumental task given the inner war that goes on inside the mind of an individual diagnosed with D.I.D. From an ego-state theoretical framework, this article will demonstrate through clinical cases and artwork, the value of imagery techniques in changing internal perceptions, especially with regards to introject ego states...

Manifestations of chronic shock and annihilation anxiety-including autistic defenses, chaotic relationships, disorganized attachment, split-off affective states, and vulnerability to disintegration--exist side by side with apparent ego strength and high functioning, even in nonabused patients. Chronic shock stemming from uncontained distress and failed dependency during childhood can persist throughout the lifespan, creating ripples of dysfunction that mask as character distortion and contribute to therapeutic impasse...

INTRODUCTION: ''Autoscopic phenomena refer to different illusory reduplications of one's own body and self. This article proposes a phenomenological differentiation of autoscopic reduplication into three distinct classes, i.e., autoscopic hallucinations, heautoscopy, and out-of-body experiences (OBEs). METHOD: Published cases are analysed with special emphasis on the subject's point of view from which the reduplication is observed. RESULTS: In an autoscopic hallucination the observer's perspective is clearly body-centred, and the visual image of one's own body appears as a mirror reversal...

This essay discusses how the organisation of mental material within the cognitive system can influence consciousness and awareness, and presents a theory of dissociation based on the premise that awareness is relative, contingent on the activated representation of the ongoing event being linked to the activated self-representation. It allows four possible variations of integration: (i) non-integrated experience--perceptions about an object/event are either not perceived or they remain at the sensory level: traditional dissociative states, amnesia, depersonalisation etc; (ii) variably integrated experience--activation of information of a specific valence about an object blocks activation of information of contrasting valence: splitting; (iii) alternatively integrated experience--experience is integrated into a specific, limited active self-representation: fugue and multiple identity states; (iv) dis-integrated experience-the ongoing experience of innate drives and needs is no longer consistently activated in the core self-representation: repression and isolation...

The analyst makes a series of considerations taken--a posteriori--from the analysis of a small number of patients. These patients have saved themselves from an early narcissistic catastrophe by developing precocious mental processes, while affective relationships rudimentarily repeat the impact with the original trauma. Primitive defences, essentially denial and vertical splitting, dissociate the tear in the psyche and structure a 'narcissism-autism bipolarity', revealed in aspects of the character which oblige the patient to automatically repeat a single matrix of experience...

Much of the literature focuses on the pathology that falls to the far right of the Watkins (1997) differentiation-dissociation continuum, such as Dissociative Identity Disorder and Dissociative Disorder NOS. Adding a "far left" to this continuum, as well as a construct of what the "far left" looks like, makes apparent the value of healthy adaptive differentiation for those individuals that fall to the "far left" of the spectrum; those who don't differentiate enough. A discussion of sexual dysfunction at this end of the continuum and cases of Hypoactive Sexual Desire Disorder and Vaginismus demonstrate the clinical effectiveness of an approach combining hypnosis and ego-state therapy to facilitate healthy adaptive differentiation...

This paper draws attention to a particular use of the body, one in which basic psychical security is achieved through a radical detachment from body vitality, necessitating the creation of a coercive regime of psychosomatic control and autostimulation for purposes of artificial enlivenment of the self. When the personality is organized predominantly along the lines of a systematic dissociation (and then pseudo-integration) of the mental and the somatic realms of psychical life, the psyche-soma undergoes a far-reaching transmutation: the desiring body is eclipsed and replaced with a fabricated body...

J. A. Lambie and A. J. Marcel (2002) outlined a framework for understanding varieties of conscious emotion experience. In their analysis, the self plays an important role in conscious emotion experience. In this critique, however, the authors propose that Lambie and Marcel's presentation of the self needs further specification if it is to account for varieties of conflicted emotional experience, particularly those characteristic of dissociative states. The authors propose that a more elaborated self-construct is necessary to account for these phenomena involving either the "splitting off of significant self-related concerns or the existence of multiple self-constructs...